Shavuot Redux~ How Many Letters are in a Sefer Torah?

In honor of shavuot that celebrates the giving of the torah, a repost from the talmudology archives.

קידושין ל, א

לפיכך נקראו ראשונים סופרים, שהיו סופרים כל האותיות שבתורה, שהיו אומרים: וא"ו דגחון חציין של אותיות של ספר תורה, דרש דרש  חציין  של תיבות, והתגלח של פסוקים

Therefore the early sages were called "counters" - soferim - because they counted all the letters of the Torah. They used to say: the letter vav of the word Gachon (Lev.11:42) is the half-way point of the letter of a Torah. The words "darosh darash" (Lev. 10:16) represent the half way point of the number of words in the Torah. The verse that begins with the word "Vehitgalach" (Lev.13:33) is the half way point of the number of verses in the Torah...

This page of Talmud covers some important material for those interested in the way in which Judaism and science interact.   The business of counting the letters in the Torah was apparently taken very seriously - so much so that one of the names by which the rabbis of the Talmud were known  - soferim - means "those who count."  To this day, the person who handwrites a Sefer Torah is called a counter (סופר), and not a writer (כותב). The Talmud emphasizes that this counting exercise was taken so seriously that the letters, words and verses were counted, and counted again. 

קידושין ל, א

בעי רב יוסף וא"ו דגחון מהאי גיסא או מהאי גיסא א"ל ניתי ס"ת ואימנינהו מי לא אמר רבה בר בר חנה לא זזו משם עד שהביאו ספר תורה ומנאום

Rav Yosef asked a question: This letter vav of the word Gachon, is it part of the first half or part of the second half of the letters of the Torah? They said to him, "let us bring a Torah scroll and count! For didn't Rabbah bar bar Channah say in a similar context: "They did not move from there until they brought a Torah scroll and counted all its letters"...

The View of Tradition, And OF the Journal Tradition

Writing in Tradition in 1964, the late scholar Louis Rabinowitz (d. 1984) asked how Orthodox Jews should regard the text of the Torah , "...upon which depends the whole enduring magnificent structure of the Oral Law and the Halakhah, in comparison with those texts which show variants from it?"  Here is his reply:

“The answer is surely simple and logical. “The early scholars were called Soferim,” declares the Talmud (Kid. 30a) “because they were wont to count (soferim) all the letters of the Torah.” The meticulous manner in which they carried out this task is sufficiently indicated in the same passage by the information which it elicited to the effect, for instance, that the vav of gachon (Lev. 9:42 - [sic]) marks the half-way mark of the letters of the Torah, the words darosh darash of Lev. 10:16 the dividing line between the words...


With what loving care and sacred devotion, then, did they jealously guard every letter of the text! What exhaustive and detailed regulations they laid down in order to ensure that the copying of the scrolls should be completely free from human error! There has been nothing like it in the history of literature or religion, and in this respect the Massoretic text stands indisputably in a class by itself.”

— Louis Rabinowitz. Torah Min Ha-Shamayim.Tradition: A Journal of Orthodox Jewish Thought, 1964-5: 7;1: 34-45

Leaving aside the ironic typographic error that mis-references the location of the vav of Gachon, was the late rabbi Rabinowitz correct in remarking on the "loving care and sacred devotion," with which "they jealously guard every letter of the text"?

So how many letters are there in a Torah?

There are varied counts given for the number of letters in the Torah, but a couple of results seem to be most popular.

• 304, 805 From here, and here and here, and from Even-Shoshan (see below).

• 304,801 From here.

One website shares the source code used to count the words and letters in Torah; its results are shown below, and are off by four when compared to others who claim to have counted.

Letters and Words in the Torah
	Words	Lettlers
בראשית	20,614	78,063
שמות	16,714	63,527
ויקרא	11,950	44,790
במדבר	16,408	63,529
דברים	14,295	54,892
TOTAL	79,981	304,801

And How Many Verses Are There?

The same website gives a count of 5,844 verses in the Torah.  Rabbi Yair Chaim ben Moses Bachrach (d. 1702), author of the Chavot Ya'ir, notes that there are 5,845 verses in the chumashim he used. But today's daf of Talmud records that there are 5,888 verses. And here is the count from Even-Shoshan's קונקורדנציה חדשה (New Concordance of the Bible):

From Even-Shoshan (ed.) A New Concordance of the Bible. Kiryat Sefer, Jerusalem 1987.

Side-Bar: From Where did Even-SHoshan Get his word count?

Even-Shoshan lists his reference as Rabbi Chaim Mordechai Brecher, who published a Yiddish translation of the entire Hebrew Bible. (Brecher was born in what is now the Ukraine in 1880 and died in New York in 1965.  His Yiddish translation was published in New York in 1941, and was republished six times, the last in 1957.)  At the end of the second volume of his translation (p. נא), R. Brecher addressed the thorny question of the letter and word counts in our Torahs, and had this to say:

The truth is, this [question of how many words there are in a Sefer Torah] is astonishing, and I couldn't rest because of it. So I decided to count them, and I, myself, counted all the words in the entire Torah. In order to make it clear to the reader that I didn't make a mistake in my count, I am here providing a list of all the verses in all the chapters as they are currently divided...My count is correct. As the ancient wise men say: Love Plato, love Aristotle, and love the truth most of all.

R. Brecher's total word count is 79,976 (although this count actually comes from here) - and so his half way point in the Torah is word #39,988. 

The Misplaced Middle of the Torah

Now back to today's page of Talmud. According to it, the middle letter of the Torah is the Vav of the word Gachon, (גחון) found in פרשת שמיני. However this claim is way off. Since there are about 304,805 letters in the Torah scrolls in use today, (I say about because of what we have just noted regarding the precise count,) the middle letter would be letter # 152,403, the first word of this verse (Lev 8.29):

ויקרא פרק ח פסוק כט 

ויקח משה את החזה ויניפהו תנופה לפני יקוק מאיל המלאים למשה היה למנה כאשר צוה יהו–ה את משה 

However the Vav of the word Gichon, is letter #157,236 - off by 4,833 letters. Oy.

It's no better regarding the words. If we go with the actual word count as being 79,980, then the middle words are # 39,990 and #39,991. These are the words יצק אל in verse below (Lev. 8:18):

ויקרא פרק ח פסוק טו 

וישחט ויקח משה את הדם ויתן על קרנות המזבח סביב באצבעו ויחטא את המזבח ואת הדם יצק אל יסוד המזבח ויקדשהו לכפר עליו

But the middle words of the Torah, according to Today's daf, are דרש דרש found over 900 words later (Lev.10:16):

ויקרא פרק י פסוק טז 

ואת שעיר החטאת דרש דרש משה והנה שרף ויקצף על אלעזר ועל איתמר בני אהרן הנותרם לאמר

That's a lot of letters to miscount, especially if your name is "the counter." Several suggestions have been made to address these discrepancies:

1.  The text of the Torah that the rabbis of the Talmud were using was significantly different to the one we use today.  This is possible, but then why does the Talmud never cite of any of these extra words and verses? The discrepant count is about 3% - that's a lot of missing text.

2.  The rabbis in the Talmud were not good at math. Again, possible, but the Talmud claims that they took the counting so seriously that they were called COUNTERS. It also claims that they undertook the counting exercise on several different occasions.  Were they really that bad at math?

3. The rabbis in the Talmud didn't mean this count to be taken literally. While many apologists like this answer, it is at total odds with the text. The Talmud states: they counted.

4.  The rabbis guesstimated the count. Perhaps the rabbis never really counted, but guessed at where the middle of the Torah lay: somewhere in the middle of the middle of the Five Books. After that, the letter vav of the word Gachon became the official midpoint, even though it was not accurate.  The problem with this suggestion is again, that the Talmud states that the soferim actually counted, and counted again. Not that they guessed, and guessed again.  

Science, Math and Judaism

Of all the scientific disciplines, it is mathematics that is first introduced to us. We teach toddlers to count, sometimes before they can even walk, and we all pursue some kind of mathematical training through high school.  Unlike medicine or physics or biology or astronomy, mathematics is something we all do, to some degree.  And we all understand what counting means.  This passage in the Talmud is the most readily understandable example of a conflict between science and Judaism. It is a conflict in which the basic text of rabbinic Judaism declares a fact that is, well, just not a fact. Some  find this conflict to be so intellectually troubling that their only path is to reject Jewish practice. Others, equally aware of the conflict, are comfortable with their intellectual position in which the scientific inaccuracies of the Talmud require no wholesale rejection of Jewish practice. Where do you fit on this spectrum, and, perhaps more importantly, what can you do to engage in a respectful dialogue with those whose opinions on these matters are not your own?

May you be blessed with a meaningful Shavuot,

and may Israel and her neighbors know only peace.

Yoma 34b~ Knives and Quenching

The Cohen Gadol (High Priest) had to take several ritual dips into a pool of water known as a mikveh. But the water was rather cold, and the Mishnah describes how it was warmed:

משנה יומא לא, ב

אִם הָיָה כֹּהֵן גָּדוֹל זָקֵן אוֹ אִיסְטְנִיס מְחַמִּין לוֹ חַמִּין, וּמְטִילִין לְתוֹךְ הַצּוֹנֵן כְּדֵי שֶׁתָּפִיג צִינָּתָן

With regard to the immersion, if the High Priest was old and found it difficult to immerse in cold water, or if he was delicate [istenis], they would heat hot water for him on Yom Kippur eve and place it into the cold water of the ritual bath in order to temper its chill so the High Priest could immerse without discomfort.

Today’s page of Talmud elaborates on this process of warning up the ritual bath:

יומא לג,ב

תַּנְיָא, אָמַר רַבִּי יְהוּדָה: עֲשָׁשִׁיּוֹת שֶׁל בַּרְזֶל הָיוּ מְחַמִּין מֵעֶרֶב יוֹם הַכִּפּוּרִים וּמְטִילִין לְתוֹךְ צוֹנֵן, כְּדֵי שֶׁתָּפִיג צִינָּתָן. וַהֲלֹא מְצָרֵף! אָמַר רַב בִּיבִי: שֶׁלֹּא הִגִּיעַ לְצֵירוּף. אַבָּיֵי אָמַר: אֲפִילּוּ תֵּימָא שֶׁהִגִּיעַ לְצֵירוּף — דָּבָר שֶׁאֵין מִתְכַּוֵּין מוּתָּר

It was taught in a baraita that Rabbi Yehuda said: They would heat blocks of iron on Yom Kippur eve and cast them into the cold water of the ritual bath to temper its chill. The Gemara asks: But by doing so, doesn’t he harden the iron, [which is a labor prohibited on Yom Kippur]? Rav Bibi said: The temperature of the blocks of iron did not reach the hardening point. Abaye said: Even if you say that the temperature of the iron reached the hardening point, the fact that the iron hardened when he placed it in the water is an unintentional act, which is permitted. [His intention was to temper the chill of the water, not to harden the iron.]

This process of hardening hot iron by rapidly cooling it is called quenching. And that is our topic for today.

Why is Iron Quenched?

The quick answer is that when it is rapidly cooled, steel (which is an alloy of iron) is transformed into something called martensite. The rapid cooling, which can be in water or oil or even cold air, locks the carbon atoms into place alongside the iron, forming a supersaturated alloy that is much harder than ordinary steel. But for the transformation to take place the steel needs to be hot enough. As John D. Verhoeven points out in his useful (but expensive) book Steel Metallurgy for the Non-Metallurgist, not much happens to the structure when steel is below about 300F (~150C). For the steel to actually be strengthened, it is often heated to over 1,110F (540C). This is what Rav Bibi was referencing when he mentioned “the hardening point.”

A Quick History of Quenching

One of the earliest references to smelting and blacksmithing comes from the opening chapters of our Bible (Gen. 4:22):

וְצִלָּ֣ה גַם־הִ֗וא יָֽלְדָה֙ אֶת־תּ֣וּבַל קַ֔יִן לֹטֵ֕שׁ כָּל־חֹרֵ֥שׁ נְחֹ֖שֶׁת וּבַרְזֶ֑ל וַֽאֲח֥וֹת תּֽוּבַל־קַ֖יִן נַֽעֲמָֽה׃

As for Zillah, she bore Tubal-cain, who forged all implements of copper and iron. And the sister of Tubal-cain was Naamah.

So it was Tubal-Cain who, according to the Torah, was the archetypal father of all things smelting. Archeologists are not sure where or when steel was created, but it was certainly described in the poems of Homer from around the eighth century BCE:

And as when a smith dips a great axe or an adze in cold water amid loud hissing to temper it—for therefrom comes the strength of iron—even so did his eye hiss round the stake of olive-wood.

But as D. Scott Mackenize noted in his helpful article published in 2007 in Advanced Materials and Processes, the advances in metallurgical technology were located in the Arab World, India, China and Japan. By 500 BCE steel was being produced on a large scale in India. The Crusaders, he wrote, had no steel that was the equal of Islamic metallurgy. One writer from the Crusades described the the quality of a Damascus blade like this: “One blow of a Damascus sword would cleave a European helmet without turning the edge, or cut through a silk handkerchief drawn across it.”

The Italian scholar Giambattista della Porta (ca. 1535-1615) in his books Natural Magic described the temperatures of steel to be quenched:

“When the iron is sparkling red hot, that it can not be hotter, that it twinkles, they call it Silver; and then it must not be quenched, for it would be consumed. But if it be of a yellow or red color, they call it Gold or Rose color; and then quenched in Liquors, it grows harder. This color requires them to quench it. But observe that if all the Iron be tempered, the colour must be blue or violet color, as the edge of a Sword, Razor, or Lancet; for observe the second colors; namely, when the iron is quenched, and so plunged in, grows hard. The last is Ash color; and after this if it be quenched, it will be the least of all made hard.”

Mackenzie noted that his was a critical observation. “He indicates a critical range for quenching, based on the colors of the heated steel. Only when the steel is rose or yellow will the steel be hardened properly. Further, the observation of tempering colors was indicated… it led Della Porta to realize the advantages of the two-stage quench over a direct quench, and reject some of the more exotic quenching baths that was cited in earlier metallurgical literature.

One French traveller to Istanbul at the end of the nineteenth century made this observation:

"...Steel is iron, mixed with charcoal. In Damascus, 10-12 kilograms of iron was required for making one sword blade. Craftsmen mixed this ore with charcoal dust, melted it again and again, until it came to a consistency of their mind.

...Now it was required to quench it in order to give it the necessary strength, and that was the interesting point of the procedure: Europeans quench the steel in water, vegetable oil, or cattle fat, but in the East they were doing it on air. When the craftsmen were done with the processing of the metal, they heated it until totally red, and gave it to a cavalry man waiting on his horse, ready for a ride. The cavalry man rode his horse in the wilderness, waving the blade in the air with crazy screams to make his horse ride faster."

This page of Talmud reminds us that sometimes the sages of the Talmud were keenly knowledgable about manufacturing processes. Rav Bibi knew a thing or two about how to quench steel, and as a result the Cohen Gadol had a warmer dip in the mikveh on Yom Kippur.

“From the earliest times, at the beginning of the Iron Age, quenching has played an important role in the growth of civilization throughout the World. .. While much of the empirical technology developed was used to increase the effectiveness of swords, knives and armor, there has been a technology transfer to other devices important to the arriving Industrial Age. Today, there is a firm grasp on heat treatment, and the mechanism of quenching, enabling special quenchants to be tailored to specific application. It was these original philosophers, alchemists and blacksmiths that are the foundation of the Science and Art of Metallurgy today.”

— D. Scott Mackenzie. History of Quenching. Advanced Materials and Processes, January 2007

Yoma 30 ~ The Talmud, Congenital Penile Malformations, and a Greek Vase

In today’s page of Talmud comes this ruling:

יומא ל, א

דְּאָמַר רַבִּי אַמֵּי: אָסוּר לְאָדָם שֶׁיֵּצֵא בְּנִיצוֹצוֹת שֶׁעַל גַּבֵּי רַגְלָיו, מִפְּנֵי שֶׁנִּרְאֶה כִּכְרוּת שפְכָה, וּמוֹצִיא לַעַז עַל בָּנָיו שֶׁהֵן מַמְזֵרִים

Rabbi Ami said: It is prohibited for a man to go out with the drops of urine that are on his legs, because he appears as one whose penis has been crushed. [A man with that condition is incapable of fathering children. People who see urine on his legs might suspect that he is suffering from that condition] and spread rumors about his children that they are mamzerim [which is a person born of a forbidden relationship. Therefore, one must be certain to brush the drops of urine from his legs].

Rabbi Ami’s teaching goes like this. If a man has drops of urine on his legs, people might think that this happened because he has a penile malformation. And if that’s the case, he couldn’t have fathered any children, because of his malformation. And if he does happen to have children, rumors will spread that they could not have been sired by the man in question. And then they might be declared mamzerim.

There is in fact a Torah prohibition forbidding a man with a penile malformation to marry (Deut 23:2):

לֹֽא־יָבֹ֧א פְצֽוּעַ־דַּכָּ֛א וּכְר֥וּת שָׁפְכָ֖ה בִּקְהַ֥ל יְהוָֽה׃

No one whose testes are crushed or whose member is cut off shall be admitted into the congregation of the Lord.

The precise meaning of these categories are not certain. But the Tosefta (a group of teachings that sort of supplement the those found in the Mishnah) adds some details:

תוספתא יבמות 10:4

איזהו כרות שפכה כל שנכרת הגיד מן העטרה ולפנים אם נשתייר מן עטרה לפנים אפי' כחוט השערה סמוך לראש ומקיף את כולה כשר ניקב מלמטה פסול מפני שהוא שופך נסתם כשר מפני שהוא מוליד וזהו פסול שחוזר להכשירו מעוך וכתות נתוק וכרות כולם בביצים דברי ר' יהודה ר"א בן יעקב אומר כולם בגיד ר' יוסי אומר מעוך וכתות בביצים נתוק וכרות בגיד

Who is considered a man “whose member is crushed (כרות שפכה)”? …a man whose hole [i.e. his urethra] is at the base of the penis is forbidden [to marry] for he is a man who spills his seed [- that is, he is incapable of fertilization].

Hypospadiasis in Greek Literature

The disorder that is described in today’s page of Talmud is a called hypospadiasis. This is a congenital (meaning birth) defect, and occurs when the penis does not form properly in utero. As a result the urethera, which is the thin tube that carries urine out of the bladder and into the toilet bowl, does not end at the tip of the penis, but rather at some other place, usually in the midline of the shaft.

It was first described by Aristotle in the 4th century BCE. He noted that boys with this disorder would sit when they urinated, rather than stand.

There have been instances of boys in whom the termination of the penis has not coincided with the passage through which the residue from the bladder passes out, so that the passage came too low; and on this account they sit in order to pass water, and when the testes are drawn up they seem from a distance to have both male and female generative organs.

Of course this would avoid the very problem that is dealt with in today’s page of Talmud, namely, how to keep spots of urine off of one’s legs. (It would seem that the sages of the Talmud didn’t think this one through…)

The term hypospadiasis comes from the Greek physician Galen, who lived some 500 years after Aristotle. Hypo means under and spadon means a fissure. Other ancient physicians also mention the malformation, like Heliodorus (1st century CE), Antyllos (2nd century CE) and the Byzantine physician Oribasius (c.320-400 CE.)

Talmudic and Modern Medical classifications of Hypospadiasis

The Talmud in Yevamot details some of the different types of hypospodiasis:

יבמות עו, א

אמר רב יהודה אמר שמואל ניקב ונסתם כל שאילו נקרי ונקרע פסול ואי לאו כשר הוי בה

רבא היכא אילימא למטה מעטרה אפי' נכרת נמי אלא בעטרה עצמה איתמר נמי אמר רב מרי בר מר אמר מר עוקבא אמר שמואל ניקב בעטרה עצמה ונסתם כל שאילו נקרי ונקרע פסול ואי לאו כשר

Rav Yehuda said that Shmuel said: If a man’s member had been punctured and it later healed and the hole closed up with flesh, in any case where, if he would emit semen, it would tear open again, he is unfit to enter into the congregation; but if not, he is fit.

Rava discussed this ruling and raised a question: Where is this perforation? If we say it is below the corona, at the end of the man’s member, why should this perforation render him unfit? Even if the member was entirely severed, he would also be fit. Rather, the hole is in the corona itself, that is, at the point where the corona meets the rest of the member. It was also stated explicitly that this is the case, as Rav Mari bar Mar said that Mar Ukva said that Shmuel said: If a man’s member had been punctured in the corona itself, and it later healed and the hole closed up with flesh, in any case where if he would emit semen it would tear open again, he is unfit; but if not, he is fit.

This discussion seems to be focussed on injuries to the penis, rather than congenital malformations like hypospodiasis, but it demonstrates that the rabbis took the classification of penile injuries and malformations very seriously. Rav Huna, for example, states that המטיל מים משתי מקומות פסול -”a man who urinates from two openings” cannot marry a Jew. This is a good description of a urethral fistula, in which there is an additional tract in the urethra that ends somewhere other than at the tip of the penis.

So much for the Talmud’s classification. Today, the disorder is classified by where the tip of the urethra (called the urethral meatus) is located, and as you can see in the diagram below, the meatus can be close to the tip of the penis, where it should be, or quite far from it. This classification is not the end of the story however, because there may be other things that make life difficult, like curvature of the penis.

The meatal locations in varying degrees of hypospadias. The potential meatal locations of hypospadias in varying presentations, ranging from glanular hypospadias to perineal hypospadias. From Chen Y et al. The current state of tissue engineering in the management of hypospadias. Nature Reviews Urology. February 2020

hypospadias in ancient Greek art

There is one (and so far only one) example of a representation of hypospadias in ancient Greek art. As Konstantinos Laios of the History of Medicine Department at the Medical School of the University of Athens in Greece pointed out in his article on the subject, it is known as the “phallus-vulva” vase, and dates back to around 610 BCE. It was discovered at Naucratis in Egypt in an unspecified sanctuary, but one probably belonging to Aphrodite. As you can just about see in the rather poor quality image from the paper, there is a hole at the base of the penis that “led archeologists to conclude that …[it] was the representation of a vulva, which was reinforced by the small-dot decoration around it. Therefore, it was believed that this decoration depicted male and female genitals seeking fertility. Moreover, in a cult or sexual context, it was associated with the god Dionysus and goddess Aphrodite.”

The so-called “phallus-vulva” vase. Part of the archaic Greek pottery of Chios. From Konstantinos Laios, Marianna Karamanou, George Androutsos. A unique representation of hypospadias in ancient Greek art. Can Urol Assoc J 2012;6(1):e1-2.

But Dr. Laios thinks there is more to this vase:

From our point of view, this phallus has the typical characteristics of a third degree penoscrotal hypospadias. The absence of the chordee is not problematic and the place of the meatus denotes an erected form to unveil the hole. This is a unique case, as other examples of hypospadias representation in ancient Greek art are not known.

Repair of Hypospodiasis - Then and Now

The Talmud in Yevamot actually records a kind of plastic surgery operation that was described by the famous Babylonia sage Abaye:

יבמות עו, א

שלח ליה רב אידי בר אבין לאביי היכי עבדינן מייתינן שערתא ומסרטינן ליה ומייתינן תרבא ושייפינן ומייתינן שומשנא גמלא ומנכתינן ליה ופסקינן ליה לרישיה ודוקא שערתא אבל פרזלא מזרף זריף וה"מ קטן אבל גדול מיקפולי מיקפל

Rav Idi bar Avin sent the following question to Abaye: What should we do to expedite the healing of such a perforation? Abaye answered: We bring a sharp-edged grain of barley and lacerate the area around the hole with it. We then bring fat and rub it on the spot, and afterward we bring a large ant [shumshena] and let it bite inside the hole. [This leads to bleeding and the formation of a scab, which eventually heals as new flesh grows there.] We also cut off the ant’s head so that it should remain in place until the wound is fully healed. And this procedure must be done specifically with a grain of barley, but an iron tool would cause inflammation [zareif ]. And this applies only to a small perforation, but a large one will eventually peel off and reopen.

(And that ant thing? It’s real, though given the location of the wound, I would think twice.) Compare the surgery recommended in the talmudic era with this description of what is around the corner:

Urethral tissue engineering has been studied for many years with increasingly promising results. However, for repair of hypospadias specifically, creation of a long, tubular construct with the ability to facilitate robust angiogenesis and fast regeneration is required. New technologies could improve generation of this type of construct. Amongst the various advances are the use of nanotechnology and 3D bioprinting. Nanotechnology enables researchers to directly influence the cellular microenvironment and influence processes such as vascularization and wound healing. In particular, nanofibres composed of synthetic or natural polymers are effective in altering the microenvironment as mod­ules of drug delivery or sensors for cellular migra­tion. Extracellular matrix­ mimicking nanofibres have been used to evaluate the spatial and temporal processes of cell emergence onto damaged or organized matrices, which can potentially be used to characterize the process of wound healing in hypospadias repair and identify risk factors for fistula formation. They are also effective in local drug delivery…

3D bioprinting also has applications in tissue engi­neering. The use of the now commercially available 3D bioprinter might enable urethral constructs to be printed with specifications tailored to each patient’s needs. Furthermore, the precision and accuracy of the printer might help make cell seeding more uniform than conventional methods.

It is a technology that is still in its infancy, but is already being used to save lives and help restore human dignity. It would take a while to explain it all to Abaye, but once he grasped the idea, he would, no doubt, be very willing to swap his barley and biting ants for a nice new shiny 3-D printer.

Future applications of 3D bioprinting and nanotechnology in hypospadias repair. The use of 3D bioprinting and nanoparticles along with cellularization to create urethral constructs for hypospadias repair. Autologous stem cells can be collected, cultured and incorporated into 3D bioprinted urethral constructs tailored to the patient’s needs and supplemented with nanoparticles for use in repair. From Chen Y et al. The current state of tissue engineering in the management of hypospadias. Nature Reviews Urology. February 2020.

Next Time on Talmudology: Sharpening Knives

Yoma 29a ~ Psalm 22 and the Husband Stitch

Psalm 22 opens with the following phrase: לִמְנַצֵּחַ עַל אַיֶּלֶת הַשַּׁחַר - and it turns out to be rather difficult to translate. One translation is “To the chief Musician upon Aijeleth Shahar,” which is not really much of a translation. Another translation is “For the leader; according to “The deer of the dawn.””

The rabbis may have understood the words, but they found the meaning of this verse to be challenging. In today’s page of Talmud there are three explanations. The first comes from Rabbi Abahu:

יומא כט,א

דִּכְתִיב: ״לִמְנַצֵּחַ עַל אַיֶּלֶת הַשַּׁחַר״, מָה אַיָּלָה זוֹ קַרְנֶיהָ מַפְצִילוֹת לְכָאן וּלְכָאן, אַף שַׁחַר זֶה מַפְצִיעַ לְכָאן וּלְכָאן.

It is as it is written: “For the leader, about the morning hind” (Psalms 22:1); just as the antlers of a hind branch out from here to there, so too, the light of dawn diffuses from here to there.

This explanation is an atmospheric one. Just as the antlers of a deer grow in several different directions, so to the light of the dawn, known as אַיֶּלֶת הַשַּׁחַר “ayelet hashahar” - is diffused in many directions.(One of the many meanings of the phrase אַיֶּלֶת הַשַּׁחַר is “the morning star, “which is the name of the planet Venus.)

Another explanation comes from Rabbi Assi, who links Queen Esther to the appearance of the dawn:

אָמַר רַבִּי אַסִּי: לָמָּה נִמְשְׁלָה אֶסְתֵּר לְשַׁחַר — לוֹמַר לָךְ: מָה שַׁחַר סוֹף כל הַלַּיְלָה, אַף אֶסְתֵּר סוֹף כל הַנִּסִּים

Rabbi Assi said: Why was Esther likened to the dawn? It is to tell you: Just as the dawn is the conclusion of the entire night, so too, Esther was the conclusion of all miracles performed for the entire Jewish people.

That’s nice. But it is on the explanation of Rabbi Zeira that we will focus:

אָמַר רַבִּי זֵירָא: לָמָּה נִמְשְׁלָה אֶסְתֵּר לְאַיָּלָה — לוֹמַר לָךְ: מָה אַיָּלָה רַחְמָהּ צַר וַחֲבִיבָה עַל בַּעְלָהּ כל שָׁעָה וְשָׁעָה כְּשָׁעָה רִאשׁוֹנָה, אַף אֶסְתֵּר הָיְתָה חֲבִיבָה עַל אֲחַשְׁוֵרוֹשׁ כל שָׁעָה וְשָׁעָה כְּשָׁעָה רִאשׁוֹנָה

Rabbi Zeira said: Why is Esther likened to a doe? It is to tell you: Just as in the case of a doe its womb is narrow and it is desirable to its mate at each and every hour like it is at the first hour, so too, Esther was desirable to Ahasuerus at each and every hour like she was at the first hour.

Rabbi Zeira here articulates a very surprising explanation, whose purpose was to praise Esther's anatomy. He claims that the vagina of the female deer (and not the uterus, even though that is the usual translation of the word rechem,) is especially “narrow” and so the male deer finds intercourse especially pleasurable. (A female deer is called called a doe or a hind, from where we get the Yiddish word for a deer - hinda.) So too, the wicked Persian King Ahasuerus longed for intercourse with Esther and found each time as pleasurable as the first.

So a couple of things. First, the vagina of a deer is not especially narrow. It is the perfect size for what it needs to do. It is no more comparatively narrow than that of a dog, a monkey, or a whale, and there no evidence whatsoever that male deer have a greater urge to mate than does the male of any other species. Indeed, it is the very presence of those other species on the planet that indicates that the mating urge of the males of each of those species is perfect, thank you very much. Even that of the Black Widow spider, in whom the tiny male mates with the larger female, only to be eaten alive, in an example of what biologists call sexual cannibalism.

Second, Rabbi Zeira’s midrashic explanation in fact tells us about his mindset, rather than revealing any fact of the natural world. A man longs for intercourse with a woman who has a narrow, or tight vagina. That is what Rabbi Zeira is saying. But before you mutter something inappropriate under your breath, you should realize that this fantasy is still prevalent, and can be found in the medical literature.

The Husband Stitch

Here is a 2020 entry from Medical News Today about “the husband stitch.”

The “husband stitch” refers to an extra stitch that some women may have received after vaginal delivery led to their perineum becoming cut or torn.

This stitch extends beyond what is necessary to repair a natural tear during childbirth or a cut from an episiotomy. The supposed purpose of the husband stitch is to tighten the vagina to its predelivery state.

It is important to note that the husband stitch is neither an accepted practice nor an approved medical procedure. Researchers have gathered most of the evidence about the husband stitch from the testimony of women who have had it and from healthcare workers who have witnessed it.

The origin of the husband stitch, or vaginal tightening surgery, traces back to the mid-1950s.

While repairing a vaginal delivery tear or episiotomy, a gynecologist would tighten the entrance of a woman’s vagina by adding an extra stitch.

Doctors stated that this procedure could improve a woman’s well-being by preserving the size and shape of the vagina, either to increase the frequency of her orgasms or to enhance a man’s pleasure in intercourse. At that time, it was also called the husband’s knot or a vaginal tuck.

Is the husband stitch an urban legend? No. Here is an excerpt from a peer-reviewed paper that appeared in Seminars in Plastic Surgery titled Aesthetic surgery of the female genitalia:

Vaginal laxity, as it is called, is a common complaint among parous women. Although women report that reduced sexual sensation is the most common specific symptom of vaginal laxity, it is not clear that this phenomenon is directly related to sexual dysfunction.

Vaginal tightening surgery has been around since the mid fifties, where gynecologists used to tighten the entrance of a woman's vagina with an extra stitch while repairing vaginal and perineum tears or episiotomies after giving birth. At that time it was notoriously known as the “husband's stitch,” the “husband's knot,” or the “vaginal tuck,” and doctors discreetly referred to this procedure as “improving a woman's well-being.”

The goal of these procedures is to reconstruct (or to narrow) the lower third of the vagina, which includes “the orgasmic platform, internal and external vaginal diameter (introitus) and the perineal body.” The procedure enhances vaginal muscle tone strength and control, and decreases internal and external vaginal diameters. Women choosing to have their vaginas tightened are generally healthy women without true functional disorders. 

In vaginal tightening procedures, portions of mucosa are excised from the vaginal fornices (via scalpel, needle electrode, or laser) to surgically “tighten” the lower third of the vagina. Presently there is no standardization of this procedure: It can be an anterior colporrhaphy, a high-posterior colporrhaphy, an excision of lateral vaginal mucosa, or a combination…known complications are localized infection and vaginal bleeding. Ninety five percent of patients treated with lateral colporrhaphy reported an improvement in sexual sensitivity, as well as greater vaginal tightness at the 6 months follow-up

Rabbi Ziera’s explanation of the first verse of Psalm 22 reflects this male fantasy, one which today, some women will accomodate by undergoing surgery. Rather than shy away from discussing these intimate and important areas of our life, the Talmud gives us an opportunity to explore them. It is up to us to do so with modesty, empathy and equity, while always giving the lead to women that for centuries, they were denied.

“They take the baby so that they may fix me where they cut. They give me something that makes me sleepy, delivered through a mask pressed gently to my mouth and nose. My husband jokes around with the doctor as he holds my hand.

– How much to get that extra stitch? he asks. You offer that, right?
– Please, I say to him. But it comes out slurred and twisted and possibly no more than a small moan. Neither man turns his head toward me.

The doctor chuckles. You aren’t the first –

I slide down a long tunnel, and then surface again, but covered in something heavy and dark, like oil. I feel like I am going to vomit.

– the rumor is something like –
– like a vir–

And then I am awake, wide awake, and my husband is gone and the doctor is gone. And the baby, where is –

The nurse sticks her head in the door.

– Your husband just went to get a coffee, she says, and the baby is asleep in the bassinet.

The doctor walks in behind her, wiping his hands on a cloth.

– You’re all sewn up, don’t you worry, he said. Nice and tight, everyone’s happy. The nurse will speak with you about recovery. You’re going to need to rest for a while.”

— Carmen Maria Machado, The Husband Stitch. Granta.